| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,949.00 | $3,949.00 | $6,907.00 | |
Aetna
| Professional | $132.15 | $132.15 | $132.15 | |
Cigna
| Professional | $178.10 | $246.20 | $349.99 | |
United
| Professional | $129.34 | $210.35 | $359.48 |